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Home My WebLink AboutBuilding Permit #105 - 47 MILTON STREET 10/14/2012 NORT PeJk-� � rBUILDING PERMIT TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION Permit NO: 16 Date Received s R,TEo SPF a 9 SACHUs�� Date Issued: IMPORTANT: Applicant must complete all items on this page bo ATION Print PRQPERTY OWNER VA-Q Print M` 210 . . . :..` ._ PARCEL:. . ZONING DISTRICT: .-Historic.District. jies. no . Nlachfile Shop-Village yes no T Y P ff OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition 9-Tw-o or more family ❑ Industrial ❑AI ration No. of units: Z- ❑ Commercial epair, replacement 0 Assessory Bldg ❑ Others: ❑ Demolition ❑ Other '0.Septic D Well p Floodplain D UVetlarids ❑ VVatersFied District. ❑,Water/Sewer. . DESCRIPTION OF WORK TO BEP RFORMED: CA"',41AW 41S Identification Please Type or Print Clearly) OWNER: Name: Qf�v:fr�g��` Phone: X78 �y X9/3 Address: A�i.*1 CONTRACTOR Name:_/t'?k?1AC0JJe Phone J CSO V �f 9 a7r-(o Address: `O � vi� 5 �� ►1 aG.�i dli► CEl COc C�i.�_� Supervisor`s.Construction License: /0 X53 .1 Exp: Date:..: Home,,:: ovem : / ent License: a�L{4 Exp. Date:` .T . d-0 a , ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDII<IC PERMIT;$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. Total Project Cost: $ g FEE: $ � Check No.: eq/(w Receipt No.: /0 s NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund P> Signature of Agent/Owner Signature of contractor � Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans El TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBodyRrt Timming Pools ❑ Well ❑ Tobacco Sales d Packaging/Sales ❑Private(septic tank,etc. ❑ Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING � DEVELOPMENT f] COMMENTS i i CONSERVATION Reviewed on Si nature COMMENTS HEALTH Reviewed on Signature COMMENTS .s Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Sa nature& Date Driveway hermit DPW Town Engineer: Signature: FIRE DpgRTMENT - Temp-Du inpster on site Located 384 Osgood Street Located at 124 Mairi Street y2S no Fire Departrnen#signature/elate COMMENTS.. Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of deter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— Eor department use I i I � i ® Notified for pickup - Date I Doc.Building Permit Revised 2010/October Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers -Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit dew Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products ®TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit IrCn all cases if a variance or special permit was required the Town CIerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording $rust be submitted with the building application Doc:Building Permit Revised 2008 1 0 Date/a � /tJ.... r t NpRTM r TOWN OF NORTH ANDOVER o� y p� PERMIT FOR MECHANICAL INSTALLATION # M + SgACNUSE This certifies that has permission for mechanical installationin the the buildings of . yT?�,a. l,�. .�9�i ! L. . . . . . . . . . . . . . . . . . at ), !�. . .t .T. . . . . ., North Andover, Mass. Fee. Lic. No.,/ . . . . . . . . . . . . . . . . . . .... . . GASINSPECTOR WHITE:Applicant CANARY: Building Dept. IPINK:Treasurer